MS-DRG

 What is an MS-DRG ? and why is it important ?

Diagnosis Related Group (DRG)
Medicare Severity - Diagnosis Related Group (MS-DRG)

 
The original objective of diagnosis related groups was to develop a classification system that helped categorize the "care" that a patient received, but not necessarily their severity of illness. Since the introduction of DRGs in the early 1980s, there has been an evolution and  today, there are several different DRG systems that have been developed in the US to try and account for some level of acuity of disease as well. A few examples include: Medicare DRGs (CMS-DRG & MS-DRG which replaced CMS DRG in 2007, All Patient DRGs (AP-DRG), All Patient, Severity-Adjusted DRGs (APS-DRG) and All Patient Refined DRGs (APR-DRG). 

Basically a DRG is a Bucket. Once a patient is assigned to a bucket , their hospital reimbursement is determined on the RW (relative weight) of the bucket. RW are (supposed to be) proportional to the cost of the care delivered, but also, since 2007, there are several levels of severity to each of those buckets. This is why, capturing the right information about patients is important. Otherwise a sick patient ends up in the not so sick bucket.

Since the release of the DRG systems, there has been discussions and debates about their impacts. We can learn so much from history and sometimes, it feels that history is not set in time.  Below is an excerpt from journal of bioethics, 1984, addressing the new DRG system and impact on policy. The conversations will continue.